甲状腺结节TI-RADS分类结果分析  

Analysis of TI-RADS classification results of thyroid nodules

作　　者：林友国[1] 陈梅青 林霞蓉[1] 杨焱 杨直[1] LIN Youguo;CHEN Meiqing;LIN Xiarong;YANG Yan;YANG Zhi(Ultrasound Diagnosis, Preventive Treatment of Disease in Traditional Chinese Medicine, The Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou 350004, P.R.China)

机构地区：[1]福建中医药大学附属人民医院治未病科彩超室

出　　处：《医学影像学杂志》2019年第8期1297-1300,共4页Journal of Medical Imaging

基　　金：福建省教育厅中青年教师教育科研项目(编号:JAT170277)

摘　　要：目的 探讨甲状腺结节TI-RADS(甲状腺影像报告及数据系统)分类法的诊断价值。方法 回顾性分析432例受试者840个甲状腺结节的TI-RADS分类结果。其中,456个结节采取穿刺活检或手术切除方式而获得病理诊断,384个结节通过长期反复复查的方式来观察声像图所发生的变化,并由此判断首次分类结果是否准确。以2类、3类、4a类定为良性,以4b类、4c类、5类定为恶性,良性分类与恶性分类采用2检验比较差异性。TI-RADS2~5依次分类,构建ROC曲线,评价TI-RADS分类法的灵敏性、特异性和准确性。结果 2类结节恶性率0.6%(1/160),3类结节恶性率2.5%(4/160),4a类结节恶性率8.7%(14/160),4b类结节恶性率37%(44/120),4c类结节恶性率73%(88/120),5类结节恶性率92%(110/120)。良性分类与恶性分类之间的差异(P<0.005)有统计学意义,840个结节的灵敏性、特异性和准确性分别为67%(242/360)、96%(461/480)、84%(703/840),ROC曲线下面积为0.773。结论 TI-RADS分类法能较好的预测甲状腺结节恶性风险,具有重要的诊断价值。Objective To investigate the diagnostic value of the TI-RADS (thyroid imaging reporting and data system) classification of thyroid nodules. Methods The TI-RADS classification results of 840 thyroid nodules in 432 subjects were retrospectively analyzed. 456 nodules were biopsy and surgical resection to obtain pathological diagnosis. Sonographic changes of 384 nodules were compared through long-term repeated review and were judged whether the first classification result was accurate. Class 2, class 3, and class 4a were defined to be benign and class 4b, class 4c, and class 5 were defined to be malignant. Benign classification and malignant classification were compared by chi-square test. TI-RADS2~5 were classified in order to construct ROC curve. The sensitivity, specificity, and accuracy of the TI-RADS classification diagnostic method were evaluated. Results The malignant rate of class 2 nodules was 0.6%(1/160). The malignant rate of class 3 nodules was 2.5%(4/160). The malignancy rate of class 4a nodules was 8.7%(14/160). The malignancy rate of class 4b nodules was 37%(44/120). The malignancy rate of class 4c nodules was 73%(88/120). The malignancy rate of class 5 nodules was 92%(110/120). The difference between benign classification and malignant classification ( P <0.005) was statistically significant. The sensitivity, specificity, and accuracy of 840 nodules were 67%(242/360), 96%(461/480), and 84%(703/840), respectively. The area under the ROC curve was 0.773 . Conclusion TI-RADS classification can better predict the malignant risk of thyroid nodules and has important diagnostic value.

关 键 词：甲状腺结节 甲状腺影像报告及数据系统 恶性风险 诊断价值 超声检查 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]